Individual provider Active NPI

Michael Salomon Radi

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1861989790
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95008333 Issued in CA
Practice address
4647 Zion Ave
San Diego, CA 92120-2507
Phone
(833) 574-2273
NPI assigned
Apr 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95008333 CA
Family Nurse Practitioner 363LF0000X NP95008333 CA Primary

Addresses

Primary practice location

4647 Zion Ave
San Diego, CA 92120-2507

Mailing address

4647 Zion Ave
San Diego, CA 92120-2507
Phone (833) 574-2273

Electronic endpoints 3

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180613002723 CA Practitioner - Nurse Practitioner 8325393440 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

8010 Frost St
FL 2
San Diego, CA 92123-4284
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95008333CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minghsun Liu, M.D., PC CurrentSince May 6, 2018 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jan 23, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 27, 2021 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Nurse Practitioner CurrentSince Jan 23, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 27, 2021 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

8010 Frost St
Fl 2
San Diego, CA 92123
Phone (800) 827-4277

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

22110 Roscoe Blvd
Ste 201
West Hills, CA 91304
Phone (818) 536-3764

Interoperability endpoints

  • Direct secure messaging: mradi24800@sharphealthcare.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1861989790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "833-574-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 ZION AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202507",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADI",
        "first_name": "MICHAEL",
        "middle_name": "SALOMON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2021-11-29",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95008333",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95008333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.